Eine effektive und sichere Kinderschmerztherapie ist aus ethischer Sicht und zur Vermeidung von negativen Langzeiteffekten wichtig. Eine qualitativ hochwertige Analgesie zu erreichen,
bleibt in dieser vulnerablen Patientenpopulation schwierig. Aktuelle Daten, Entwicklungen, Konzepte und ein kritischer Blick auf die Rolle von Opioiden können helfen, die Therapie zu
verbessern.
Abstract
Acute pain therapy in children is highly complex. Already preoperatively, the course for a successful therapy is set in the interaction with the child and parents. The goal of the
treatment is a satisfied child. This means the use of empathy and therapy planning aimed at a balance between effect and side effect and functionality. Modern concepts are opioid-sparing
and procedure-specific. Regional anaesthesia plays a major role, among other things due to excellent safety data. Knowledge of age- and block-specific local anaesthetic dosages is
essential. Little is known about pharmacodynamic data of analgesics in children. Although knowledge about pharmacokinetic characteristics is increasing, off-label use of analgesics is
inevitable. International databases such as the Kinderformularium provide up-to-date information. When using opioids, rules for safe handling must be followed both in terms of use and
prescribing. Non-opioids and adjuvants – individually or in combination – have an established place in perioperative pain management. Non-pharmacological interventions can reduce anxiety
and pain. Anxiety is one of the risk factors for chronic postsurgical pain.
Schlüsselwörter
perioperativer Schmerz - Kinder - Regionalanästhesie - opioidsparend - Analgetika
Keywords
perioperative pain - paediatric - regional anaesthesia - opioid-sparing - analgesics
